Outlines of the diseases of women / by John Phillips.

  • Phillips, John.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Outlines of the diseases of women / by John Phillips. Source: Wellcome Collection.

    71/332 (page 51)
    The results obtained by the use of this speculum are very limited. It brings the flaps of a lacerated cervix together, and hence is apt to deceive the operator as to the true condition of the cervix. It gives no view of the vaginal walls. Its advantages appear to be : (i.) less exposure in introduction, which after all is more fancied than real; (ii.) in case of acute gonorrheal vaginitis existing it enables the sound to be passed without risk of infec- tion of the endometrium; (iii.) diseased conditions of the endo- metrium can be treated by intra-uterine applications perhaps more easily. Fig. 40. (v.) The Tenaculum, invented by Sims for steadying the cervix, is simply a sharp hook of steel on a stem. r 1 The curved point, which is gradually thinned out, is three-eighths of an inch long, and is attached at slightly less than a right angle to the stem. This latter is fixed into a handle of vulcanite (Fig. 40). (vi.) The Gkim-Elastic Catheter is familiar to every student and is preferable to the silver and vulcanite instruments in use. No. 8 size should be selected. The urine having been drawn off, it must be measured and set aside for further examination. With the above description ends the list of the armamentarium necessary for diagnosis in ordinary cases of pelvic disease. III. Examination per Rectum. This should be performed by means of the left index-finger; the nail being thoroughly smeared with soap and lubricated with some antiseptic ointment, the anus should be exposed and the finger inserted into it, the subsequent direction given being Jorwards Tenaculum, and upwards. In the normal condition, the sphincter ani is felt to resist the entrance of the examining finger, but this is speedily overcome; well above its upper border a hardish smooth swelling is made out projecting into the anterior wall, pushing the mucous membrane before it and apparently blocking up the lumen of the rectum: this is the cervix uteri in its usual situation : it gives to the touch a sensation of being larger than when felt per vaginam. Above this, nothing beyond the folds of rectal mucous membrane should be detected. Abnormal Conditions to be made out per Rectum: 1. Laceration through sphincter; 2. Fissura ani, usually on the posterior wall;